Emerging treatments

Systemic corticosteroids

Corticosteroid use has been controversial in SJS/TEN. Burn surgeons consider corticosteroid therapy to be contraindicated in TEN once major skin loss has occurred (>20% total body surface area [TBSA]), especially because corticosteroids themselves can precipitate SJS/TEN.[19] One uncontrolled study used dexamethasone pulse therapy on 6 patients in the early stages of SJS/TEN. Case studies, mostly retrospective, have found that corticosteroids may be beneficial in the first few days following the appearance of the rash.[63][76][77][92]

Tumor necrosis factor (TNF)-alpha inhibitors

One systematic review including 21 case reports, four case series, and two randomized controlled trials (91 patients in total) concluded that TNF-alpha inhibitors are a safe and effective treatment for SJS/TEN.[93] Two subsequent case series demonstrated that etanercept, with or without corticosteroids, reduced mortality and healing time in patients with SJS/TEN.[94][95]

Cultivated oral mucosa epithelial sheet ocular coverage

Cultivated oral mucosal sheet transplantation offers a viable alternative for severe ocular surface diseases due to TEN, chemical, thermal, and other injury.[96][97]

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